Le Fort I miniplate osteosynthesis: a randomized, prospective study comparing resorbable PLLA/PGA with titanium

Area of Science:

• Oral and Maxillofacial Surgery
• Biomaterials Science
• Orthognathic Surgery

Background:

• Le Fort I osteotomy is a common procedure in orthognathic surgery.
• Titanium plates are traditionally used for fixation, but concerns exist regarding long-term complications.
• Resorbable materials offer potential advantages, but their long-term stability and morbidity require evaluation.

Purpose of the Study:

• To compare the long-term stability and morbidity of resorbable LactoSorb versus titanium osteosynthesis for Le Fort I osteotomies.
• To evaluate cephalometric changes and clinical outcomes in patients randomized to either fixation group.

Main Methods:

• A randomized controlled trial involving 60 patients undergoing non-segmented Le Fort I osteotomy.
• Patients were allocated to either LactoSorb or titanium fixation.
• Cephalometric analysis using tantalum micro implants was performed at multiple postoperative time points up to 1 year.

Main Results:

• No statistically significant changes in maxillary position were observed between 6 weeks and 12 months in either group.
• LactoSorb fixation showed a statistically significant, though not clinically noticeable, superior repositioning of the maxilla at 6 weeks (0.6 mm).
• The LactoSorb group experienced two cases of infection and wound dehiscence; the titanium group had three cases requiring surgical removal due to palpability.

Conclusions:

• Both LactoSorb and titanium provide satisfactory long-term stability for Le Fort I osteotomies.
• LactoSorb may be associated with a slightly higher risk of early complications like infection, while titanium implants may require removal due to palpability.
• Further research may explore optimizing resorbable materials to minimize morbidity.